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Highly accelerated compressed sensing time-of-flight magnetic resonance angiography may be reliable for diagnosing head and neck arterial steno-occlusive disease: a comparative study with digital subtraction angiography

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Abstract

Introduction

We aimed to investigate the utility of compressed sensing time-of-flight magnetic resonance angiography (CS TOF-MRA) for diagnosing intracranial and cervical arterial stenosis by using digital subtraction angiography (DSA) as the reference standard.

Methods

Thirty-seven patients with head and neck arterial stenoses who underwent CS TOF-MRA and DSA were retrospectively enrolled. The reconstructed resolution of CS TOF-MRA was 0.4 × 0.4 × 0.4 mm3. The scan time was 5 min and 2 s. The image quality of CS TOF-MRA was independently ranked by two neuroradiologists in 1031 arterial segments. The luminal stenosis grades on CS TOF-MRA and DSA were analyzed in 61 arterial segments and were compared using the Wilcoxon signed-rank test. The ability of CS TOF-MRA to predict moderate to severe stenosis or occlusion was analyzed.

Results

The image quality of most arterial segments (95.2%) on CS TOF-MRA was excellent. Arterial segments with low image quality were mainly the V3–4 segments of the vertebral artery. The majority of arterial stenoses (62.3%) were located in the cervical internal carotid artery. The luminal stenosis grades of CS TOF-MRA were concordant with that of DSA in 50 of 61 segments (p = 0.366). CS TOF-MRA had a sensitivity of 84.4% and a specificity of 88.5% for predicting moderate to severe stenosis. For detecting occlusion lesions, it had a sensitivity of 100% and a specificity of 94.1%.

Conclusion

CS TOF-MRA provides adequate image quality within a reasonable acquisition time and is a reliable tool for diagnosing head and neck arterial steno-occlusive disease.

Key Points

• CS TOF-MRA provides a relatively large coverage (16 cm), high resolution (0.4 × 0.4 × 0.4 mm 3 ) and good image quality of head and neck arteries within 5 min and 2 s.

• The diagnostic accuracy of CS TOF-MRA in the assessment of moderate to severe stenosis and occlusion was comparable with that of DSA.

• Arterial segments with low image quality were mainly the V3 and V4 segments of the vertebral artery.

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Abbreviations

ACA:

Anterior cerebral artery

BA:

Basilar artery

CS TOF-MRA:

Compressed sensing time-of-flight magnetic resonance angiography

DSA:

Digital subtraction angiography

ICA:

Internal carotid artery

MCA:

Middle cerebral artery

mFISTA:

Modified fast iterative shrinkage-thresholding algorithm

NASCET:

North American Symptomatic Carotid Endarterectomy Trial

PCA:

Posterior cerebral artery

PI:

Parallel imaging

SNR:

Signal-to-noise ratio

VA:

Vertebral artery

WASID:

Warfarin Aspirin Symptomatic Intracranial Disease

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Funding

This study has not received any funding.

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Author notes

  1. Xuan Zhang and Yue Zhou Cao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Gulou district, Nanjing, Jiangsu Province, China

    Xuan Zhang, Yue Zhou Cao, Xi Hu Mu, Shan Shan Lu & Xun Ning Hong

  2. MR Collaboration, Siemens Healthcare Ltd., Shanghai, China

    Yi Sun

  3. Siemens Healthcare GmbH, Erlangen, Germany

    Michaela Schmidt, Christoph Forman & Peter Speier

Authors
  1. Xuan Zhang
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Correspondence to Shan Shan Lu or Xun Ning Hong.

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The scientific guarantor of this publication is Xun Ning Hong.

Conflict of interest

Authors Yi Sun, Michaela Schmidt, Christoph Forman, and Peter Speier are employees of Siemens Healthcare. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

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Zhang, X., Cao, Y.Z., Mu, X.H. et al. Highly accelerated compressed sensing time-of-flight magnetic resonance angiography may be reliable for diagnosing head and neck arterial steno-occlusive disease: a comparative study with digital subtraction angiography. Eur Radiol 30, 3059–3065 (2020). https://doi.org/10.1007/s00330-020-06682-3

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  • DOI: https://doi.org/10.1007/s00330-020-06682-3

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